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Cholesteatoma

Last reviewed: 10 Nov 2024
Last updated: 10 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • hearing loss
  • ear discharge resistant to antibiotic therapy
  • attic crust in retraction pocket
  • white mass behind intact tympanic membrane
Full details

Other diagnostic factors

  • tinnitus
  • otalgia
  • altered taste
  • dizziness
  • facial nerve weakness
Full details

Risk factors

  • middle ear disease
  • eustachian tube dysfunction
  • otologic surgery
  • traumatic blast injury to ear
  • congenital anomalies
  • family history
Full details

Diagnostic tests

1st tests to order

  • pure tone audiogram
  • CT scan of the petrous temporal bones
Full details

Tests to consider

  • fistula test
  • MRI scan of the head and petrous temporal bones
  • bacterial culture
Full details

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Susan A. Douglas, MBBS (Hons) UWI, FRCSEd, FRCS (ORL-HNS)

Consultant Otolaryngologist and Otologist

Rotherham NHS Foundation Trust

Rotherham

UK

Disclosures

SAD declares that she has no competing interests.

Peer reviewers

Cliff Megerian, MD

Professor and Vice Chairman of Otolaryngology

Case Western Reserve University School of Medicine

Cleveland

OH

Disclosures

CM is an author of a reference cited in this topic.

Iain Swan, MD, FRCS

Senior Lecturer in Otolaryngology

Honorary Consultant Otolaryngologist

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

IS declares that he has no competing interests.

  • Cholesteatoma images
  • Differentials

    • Chronic suppurative otitis media
    • Otitis externa
    • Benign necrotizing otitis externa
    More Differentials
  • Guidelines

    • Hearing loss in adults: assessment and management
    • Otitis media with effusion in under 12s
    More Guidelines
  • Patient information

    Middle ear infection

    Outer ear infection

    More Patient information
  • Videos

    How to examine the ear

    More videos
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